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Endothelin in chronic renal failure.

G Deray1, A Carayon, G Maistre

  • 1Department of Nephrology, Hospital Pitie-Salpetriere, Paris, France.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1992
PubMed
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Plasma endothelin (ET) is significantly elevated in patients with chronic renal failure, including those undergoing hemodialysis and continuous ambulatory peritoneal dialysis (CAPD). Renal clearance of ET was not observed in dogs or humans, and hydration did not affect ET levels.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiovascular Physiology

Background:

  • Endothelin (ET) is a potent vasoconstrictor peptide.
  • Chronic renal failure is associated with various cardiovascular complications.
  • The role of ET in renal failure and its clearance mechanisms require further investigation.

Purpose of the Study:

  • To determine plasma endothelin (ET) levels in patients with chronic renal failure.
  • To investigate the renal clearance of endogenous ET in normal dogs and humans.
  • To assess the effect of acute volume expansion on ET levels.

Main Methods:

  • Plasma ET concentrations were measured in hemodialysis patients (pre- and post-dialysis), non-dialyzed uremic patients, and CAPD patients.
  • Renal ET clearance was assessed by comparing ET levels in arterial and venous blood samples in dogs and humans.

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  • The impact of intravenous isotonic saline infusion on plasma ET was evaluated in healthy subjects.

    • Main Results:

    • Plasma ET levels were significantly elevated in hemodialysis patients (57.5 pg/ml pre-, 52.5 pg/ml post-dialysis) and CAPD patients (63 pg/ml) compared to controls (20.8 pg/ml).
    • Non-dialyzed uremic patients also showed elevated ET levels (mean 38.2 pg/ml).
    • No significant ET clearance was observed across the dialyzer membrane, across the kidney in dogs (aorta vs. renal vein), or in humans (renal artery vs. renal vein).
    • Acute volume expansion with saline did not alter ET levels in healthy subjects.

    Conclusions:

    • Plasma ET is significantly elevated in patients with chronic renal failure, particularly those on dialysis (hemodialysis and CAPD).
    • The kidneys do not appear to clear endogenous ET in dogs or humans.
    • Acute volume expansion does not influence plasma ET levels.